Inspection on 02/11/05 for Lindisfarne Residential Home

This inspection was carried out on 2nd November 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Poor. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Lindisfarne Residential Home 04/12/07

Lindisfarne Residential Home 02/02/07

Lindisfarne Residential Home 12/05/05

Lindisfarne Residential Home 08/03/05

Lindisfarne Residential Home 14/09/04

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOMES FOR OLDER PEOPLE Lindisfarne Residential Home Whitehall Park Chester Le Street Durham DH2 2EP Lead Inspector Mrs Tanya Newton Unannounced Inspection 2nd November 2005 09:30 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Lindisfarne Residential Home DS0000007487.V251258.R01.S.doc Version 5.0 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Lindisfarne Residential Home DS0000007487.V251258.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Lindisfarne Residential Home Address Whitehall Park Chester Le Street Durham DH2 2EP Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 0191 3883717 0191 3882808 Gainford Care Homes Limited Elsie May Hanson Care Home 30 Category(ies) of Dementia - over 65 years of age (30) registration, with number of places Lindisfarne Residential Home DS0000007487.V251258.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. Named Individual: The home may accommodated a named individual as set out in a letter to the registered person dated 5th August 2004 which establishes the basis on which the individual`s needs will be met by the home. Where necessary the homes Statement of Purpose shall reflect any changes in service provision required for this arrangement. This condition may not apply to anyone else, other than the named individual, who falls outside the registered category. Named Individual The home may accommodate a named individual as set out in a letter to the registered person dated 29 April 2005 which establishes the basis on which the individual needs will be met by the home. Where necessary the home`s Statement of Purpose shall reflect any changes in service provision required for this arrangement. This condition may not apply to anyone else, other than the named individual, who falls outside the registered category. 12th May 2005 2. Date of last inspection Brief Description of the Service: Lindisfarne residential home provides care for up to 28 service users with dementia. The home is built over two floors with lift access; the home is situated within a housing estate in Chester-le-street, which is a town close to Durham. The home is part of the Gainford Care Home Group. Lindisfarne Residential Home DS0000007487.V251258.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was carried out on the 2nd of November between the hours of 9.30 and 3.30. This was the second annual inspection of the home. Five staff, six residents and two visitors/relatives were spoken to during the inspection and some of their comments have been included within the report. In line with current CSCI policy on “proportionality” the inspection focused on a number of core standard outcomes for service users. What the service does well: What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Lindisfarne Residential Home DS0000007487.V251258.R01.S.doc Version 5.0 Page 6 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Lindisfarne Residential Home DS0000007487.V251258.R01.S.doc Version 5.0 Page 7 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3 The assessment process could be further improved to demonstrate how the home will meet the individual needs of the service users placed. EVIDENCE: The assessments viewed during the inspection were not up to date and there were lots of gaps in the recording of information. Assessments form the basis from which the individual plan of care will be written and demonstrate how the home will meet an individuals needs. The information provided within assessments must cover all areas of physical, social, emotional and psychological needs. Where possible service users and/or their relatives should be involved in the assessment process. Lindisfarne Residential Home DS0000007487.V251258.R01.S.doc Version 5.0 Page 8 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8 & 9 Care plans should include specific information relating to residents health needs. Medication recording systems need to be improved so that the home has an audit trail of any medication administered. EVIDENCE: Each service user has a plan of care, which details how the home will meet their needs. Two care plans were looked at during the inspection, in the main these were well written, however more specific information needs to be included regarding peoples health care needs. One of the care plans viewed was for a resident who is diabetic, although this was included within the section of eating and drinking; there was nothing about diabetes under a health section. Another resident was at risk from choking; again there was no care plan in place to support this. Comments from relatives included “the home is very good, mum is well looked after and kept nice and clean” A check on the medication systems was also carried out, there were a number of missed signatures on the drug recording sheets. Staff must sign these sheets as they provide an audit trail of medication, which has been given. The district nurse said that they were keen to provide training to staff and was positive about the care being provided within Lindisfarne. Lindisfarne Residential Home DS0000007487.V251258.R01.S.doc Version 5.0 Page 9 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 14 & 15 The menus need to be developed based on the likes, dislikes and nutritional needs of the residents. EVIDENCE: Most of the staff spoken to felt that residents were supported in making choices such as what time they wanted to get up or go to bed, residents did not feel that they were given choices regarding the menus provided. The comments about the food were concerning, staff said that food was often burnt and that service users on a liquidised diet often received the same liquidised dinner twice in a day as there was no alternative. Diets for service users with diabetes were said to be very poor, despite guidance from a dietician items such as semi skimmed milk were unavailable, staff said that they often had to buy the required foods from petty cash. A discussion took place between the cook and the inspector, the cook is based on site in the nursing home and food is transported over to the residential home in a hot food trolley. Although a previous agreement had been made for kitchen staff to serve the meals, this did not happen on the day of the inspection. It is recommended that the cook meet with both of the site managers on a regular basis and that feedback regarding the menus is sought. Feedback from service users and relatives regarding the food was mixed and included comments such as “the dining arrangements are better, the food is good” and “I want more variety such as Lindisfarne Residential Home DS0000007487.V251258.R01.S.doc Version 5.0 Page 10 roast potatoes, roast beef and Yorkshire puddings – we have the same thing every day of every week, there’s no variety, why can’t we have a nice cream cake for tea, they think because we are old anything will do”. Staff said that they would like salad and fresh fruit to be readily available. There were many other comments regarding the food some positive and some negative, menus need to be developed based on the likes, dislikes and nutritional needs of the residents. Lindisfarne Residential Home DS0000007487.V251258.R01.S.doc Version 5.0 Page 11 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): EVIDENCE: None of these standard/outcomes were assessed during this inspection; they were looked at in the previous inspection, which took place in May this year. Lindisfarne Residential Home DS0000007487.V251258.R01.S.doc Version 5.0 Page 12 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): EVIDENCE: None of these standard/outcomes were assessed during this inspection; they were looked at in the previous inspection, which took place in May this year. Lindisfarne Residential Home DS0000007487.V251258.R01.S.doc Version 5.0 Page 13 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27 & 30 Training for staff needs updating and should be based around meeting the needs of the service users accommodated EVIDENCE: Six care staff work on a morning shift and five on a late shift, three staff work during the night. The numbers of staff working a late shift had decreased by one. Staff feedback included “we are run off our feet” and “we are short staffed, there’s increased work now that service users are bought downstairs for meals”. Staff files could not be examined as no one had access to the staff filing cabinet. The staff training records were not up to date, some courses had been booked, the manager must ensure that all staff are up to date in manual handling, first aid, food hygiene and fire, training records must also be maintained. One staff member said that they had not had an induction and would not know what action to take in the event of a fire; an immediate requirement notice which is a letter telling the home to take immediate action was given regarding this. Lindisfarne Residential Home DS0000007487.V251258.R01.S.doc Version 5.0 Page 14 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 38 The home must implement safe systems to monitor the health safety and well being of service users and staff. EVIDENCE: Although water temperatures were being checked the records need to be dated and signed. There were no fire records available, the last fire and emergency light check records were dated the 7th October. Staff stated that the maintenance man had been busy at another home. Weekly checks must be carried out in the absence of the handyman. Lindisfarne Residential Home DS0000007487.V251258.R01.S.doc Version 5.0 Page 15 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 2 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 2 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 X 14 2 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 X X X X X X X X X STAFFING Standard No Score 27 2 28 X 29 X 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X X X X X X 1 Lindisfarne Residential Home DS0000007487.V251258.R01.S.doc Version 5.0 Page 16 Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 2 3 Standard OP3 OP7 OP9 Regulation 14(1)a 15(1) 13(2) Requirement Assessments must be fully completed for all service users. Care plans must be in place for all areas of resident’s health care needs. The registered person must ensure that medicines are recorded, handled and safely administered in line with prescribers instructions at all times. Menus must be reviewed with feedback from residents. Staff induction and training must be kept up to date with accurate records maintained. The registered person must ensure that water temperature checks are carried out in the absence of the maintenance man and that a record of these temperatures is maintained. All health and safety checks must be recorded. Timescale for action 30/12/05 30/12/05 30/12/05 4 5 4. OP15 OP38OP27 OP30 OP38 16(i) 18(1)i 23 30/12/05 30/12/05 30/12/05 Lindisfarne Residential Home DS0000007487.V251258.R01.S.doc Version 5.0 Page 17 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard OP36 Good Practice Recommendations Staff supervision should be provided for all staff at least six times each year. Lindisfarne Residential Home DS0000007487.V251258.R01.S.doc Version 5.0 Page 18 Commission for Social Care Inspection Darlington Area Office No. 1 Hopetown Studios Brinkburn Road Darlington DL3 6DS National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. 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